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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371566
Report Date: 03/12/2024
Date Signed: 03/12/2024 03:29:37 PM

Document Has Been Signed on 03/12/2024 03:29 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GIVINGTREE MONTESSORIFACILITY NUMBER:
304371566
ADMINISTRATOR:RHO, YUN HEEFACILITY TYPE:
850
ADDRESS:1911 NORTH EUCLID STREETTELEPHONE:
(714) 336-2872
CITY:FULLERTONSTATE: CAZIP CODE:
92835
CAPACITY: 41TOTAL ENROLLED CHILDREN: 41CENSUS: 22DATE:
03/12/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:Seong Mi SonTIME COMPLETED:
03:45 PM
NARRATIVE
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On 3/12/2024, Licensing Program Analysts (LPA) A. Silva and A. Castro conducted a Case Management – Deficiencies due to deficiencies observed. Upon arrival, the LPAs meet with Licensee Seong Mi Son. An on-site Facility Personnel Report Summary review indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Census was 22 preschool children at the time of visit. The facility was operating within ratios and capacity. Korean interpreter ID 3157860 assisted with translation during the visit.

The licensee did not ensure that children in two classrooms were supervised as required by regulations. During the visit there were eight preschool children in the Bear room and eight preschool children in the Panda room. The LPAs observed the children without supervision while staff walked to open the front door for parents dropping children off. One teacher walked about 50 feet away from the classroom and passed near the LPAs. There was no visual from the point where the teacher and LPAs were standing. Another teacher walked out of the classroom about 10 feet away while the children were in the classroom. The LPAs also observed children walking between the classroom and the playground without any supervision. The Director was informed that per CCR 101229(a)(1) Responsibility for Providing Care and Supervision (1) No child(ren) shall be left without the supervision of a teacher at any time. A citation was issued.

The licensee did not report to the department that the former director stopped working at the facility. According to the licensee, the director stopped working four months ago and is on leave. The licensee does not know when the former director will come back. Based on CCR 101212(b) Reporting Requirements, the name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). The licensee did not report the change. A citation was issued.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GIVINGTREE MONTESSORI
FACILITY NUMBER: 304371566
VISIT DATE: 03/12/2024
NARRATIVE
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Based on records review and interviews, the facility is being cited in accordance with the California Code of Regulations, Title 22, Division 12, for the following section: 101229(a)(1) Responsibility for Providing Care and Supervision and 101212(b) Reporting Requirements.

Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was provided and must remain posted for 30 days. Exit interview conducted and report was reviewed with director Seong Mi Son.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024
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Document Has Been Signed on 03/12/2024 03:29 PM - It Cannot Be Edited


Created By: Archibaldo Silva On 03/12/2024 at 03:16 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GIVINGTREE MONTESSORI
FACILITY NUMBER: 304371566

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/12/2024
Section Cited
CCR
101229(a)(1)

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101229(a)(1) Responsibility for Providing Care and Supervision. (1) No child(ren) shall be left without the supervision of a teacher at any time.
The licensee did not meet the regulation above as evidenced by:
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The licensee Seong Mi Son stated she will create a program to ensure appropriate care and supervision is provided to children. The proof of completion will be emailed to LPAs.
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Based on observation, the licensee did not meet theregulation above in 16 of 22 children present which poses a potential risk to children. The LPAs observed the children without supervision for several seconds at a time while the teachers walked to the front door.
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Type B
04/12/2024
Section Cited
CCR101212(b)

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101212(b) Reporting Requirements. The name of the child care center director ... shall be reported to the Department within 10 days of a change.
The licensee did not meet the above regulations as evidenced by
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Licensee Seong Mi Son stated a new director will be assinged and proof of correction will be emailed to the LPAS.
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Based on interview statements, the director stopped working about 4 months ago. The licensee said she didn't assing a new director or new person to be responsible. This change was not reported to the department.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Patricia Magana
LICENSING EVALUATOR NAME:Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2024


LIC809 (FAS) - (06/04)
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